Patient Information - New Patients

The Physicians and staff of this office would like to welcome you. We hope we can make your visit as pleasant and comfortable as possible.

An appointment is set up especially for you. Make every effort to keep your appointment as we will not re-schedule your appointment after a third "no-show" without proper notice, unless it is due to an emergency. If you are unable to keep your appointment please call this office 24 hours in advance to cancel. If you are referred to us by your primary care physician or other doctor, you may need to obtain an authorization for your visit to our office. Please contact your primary care physician and they will assist you in obtaining an authorization. It is standard practice for this office to collect co-pays and or deductibles at time of service, however we will file with your insurance carrier as a courtesy. Please bring your insurance card with you to avoid any delays or denials from your insurance.
In order for the doctors to make a recommendation on your illness, it is necessary that you bring a list of all your medications, medical records and any X-rays taken for review. If you do not have these records, please let us know, and we will assist you in obtaining them. We are here to help you and hope that we can provide you with the best possible care. We look forward to seeing you.

Your Physician has referred you to our office for your medical condition. Call your primary care physician to obtain a referral number if necessary, and to request copies of any lab work, X-ray reports, or other pertinent data that will be relevant to your visit, these reports can be either mailed, faxed to our office (503-362-7344) or hand carried at time of appointment.

YOUR RESPONSIBILITIES:

• INSURANCE: Insurance plans vary considerably and we cannot predict or guarantee what part of our services will or will not be covered by your particular insurance. You are ultimately responsible for all medical expenses and we will expect you to pay any balances not covered by insurance. Many insurance plans do not pay for wellness, routine, and/or surveillance visits and/or guarantee benefit coverage. This is your responsibility.
  
  
• If your insurance plan requires pre-authorization, please inform our office staff so that we can assist you in this process. Failure to pre-authorize will result in non-payment by your insurance; thus, the entire bill will be your responsibility. Pre-authorization and benefit coverage are two different things. You, as the patient, must verify benefit coverage.
  
  
• If you experience financial circumstances beyond your control, our practice, as a courtesy, will establish a reasonable weekly/monthly payment plan to accommodate your needs.
  
  
• RESCHEDULING OR CANCELLATION OF PROCEDURES: If your procedure needs to be rescheduled, we ask that you notify our office as soon as possible. Because of the volume of patients who need to have procedures performed. There will be a $200 charge to patients who do not present for procedures or who cancel with less than 72 hour notice. This is your responsibility and will not be covered by your insurance company.
  
  
• PROCEDURES AT SALEM ENDOSCOPY CENTER: When you have a procedure performed at Salem Endoscopy Center, LLC, you will receive a bill from Salem Endoscopy Center for the facility, a bill from Salem Gastroenterology Consultants, PC for the physician performing the procedure. If a tissue specimen is taken during your procedure, you will receive a separate bill from the facility where the tissue is processed and possibly a bill from the pathologist who examines the tissue.
  
  
• PROCEDURES AT A HOSPITAL OR OUT-PATIENT FACILITY: You will receive a bill from the facility where your procedure is performed, possibly a bill from the anesthesiologist administering the anesthesia, and a bill from Salem Gastroenterology Consultants, PC for the physician performing the procedure. If a tissue specimen is taken during your procedure, you will receive a separate bill from the facility where the tissue is processed and possibly a bill from the pathologist who examines the tissue.
  
  
• LABS AND X-RAYS: When blood work or x-rays are ordered by Salem Gastroenterology Consultants, PC YOU must check with your insurance company regarding where you are permitted to have these tests performed and whether or not these tests need to be pre-certified or pre-authorized. Salem Gastroenterology Consultants, PC will not be responsible for expenses incurred if you have the testing performed at a non-participating location.
  
  
• WHEN YOU HAVE AN OFFICE APOINTMENT:
  If you have insurance coverage that requires you to notify your primary care physician (family doctor) to obtain approval for your office visit, it is your responsibility to do so. If you are required to have a referral or authorization form, you must bring the form with you for every appointment you have in our office. Payment for visits that are not authorized by your primary care physician will be your responsibility at the time of the visit.
  Co-payments and patient responsibility payments are expected at the time of service.
  All patients are required to present insurance cards at every visit and every procedure. If your insurance changes, it is your responsibility to notify our office and make sure we have a copy of your new insurance card.